Literature DB >> 21333212

Re: JSLS(2009);13(3):346-349. Long-term study of port-site incisional hernia after laparoscopic procedures.

Rajaraman Durai, Philip Ch Ng.   

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Year:  2010        PMID: 21333212      PMCID: PMC3041056     

Source DB:  PubMed          Journal:  JSLS        ISSN: 1086-8089            Impact factor:   2.172


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Dear Editor, We read the article written by Hussain et al[1] with interest. In our recent experience, we have seen 5 epigastric port-site hernias. All procedures were performed by different laparoscopic surgeons. We use 1 of 3 methods in closing 10-mm ports to prevent the formation of port-site hernia. They are sheath tilt, Langenbeck's lift, and Sucker through port techniques. It is universally agreed that the closure of the port site should include approximation of the sheath. We have described the sheath tilt and Langenbeck's lift previously.[2] For epigastric port sites, we found the 10-mm sheath tilt requires a slight extension of the skin incision to access the sheath. We use a third method, which we call the “Sucker through port” method. In this method, the sucker for irrigation is inserted to the 10-mm port, and the sheath is pulled out. By tilting the sucker and simultaneously retracting the skin with a medium Langenbeck's retractor, one can visualize the sheath clearly. By tilting the sheath on either side, one can take a full-thickness bite of the sheath. Care should be exerted when inserting the suction cannula to ensure that it is not inserted too deeply to avoid damage to intestinal viscera. We always close the 10-mm ports, in particular all epigastric ports, with a 0 PDS J needle. We have not come across a single case of port-site incisional hernia even after several years of surgical practice. The suction catheter is passed via a 10 mm port and used to lever the fascial sheath and the skin is retracted with a Langenbeck's retractor. This enables full thickness fascial stitch and the surgeon will be able to close the 10 mm port and therefore preventing 10 mm port-site incisional hernia.
  2 in total

1.  Novel methods of closing 10-mm laparoscopic port-site wounds.

Authors:  Rajaraman Durai; Philip C H Ng
Journal:  J Laparoendosc Adv Surg Tech A       Date:  2009-12       Impact factor: 1.878

2.  Long-term study of port-site incisional hernia after laparoscopic procedures.

Authors:  Abdulzahra Hussain; Hind Mahmood; Tarun Singhal; Santosh Balakrishnan; Jackie Nicholls; Shamsi El-Hasani
Journal:  JSLS       Date:  2009 Jul-Sep       Impact factor: 2.172

  2 in total

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